Treatment of Older Diabetic Patients With Cardiovascular Disease

In the past few years, arteriosclerosis and heart disease have become increasingly prominent as causes of death in diabetes mellitus. A recent article by Joslin¹starts with the words "Every other diabetic now dies of arteriosclerosis, and the percentage of such cases has been rapidly rising." In the period between 1894 and 1914, 15 per cent of the total number of deaths of diabetic patients in Joslin's series of 342 deaths were due to arteriosclerosis; in the period 1926-1929, the death rate from arteriosclerosis had risen to 48 per cent. The coma death rate, during the same period, had dropped from 61 per cent to 11 per cent. The organ most frequently involved by the arteriosclerotic process in Joslin's series is the heart (43.1 per cent of all arteriosclerotic deaths). Similar statistics have been published by Warren,²Wilder,³Root and Graybiel,⁴Blotner⁵and Nathanson.⁶